Additional Assessment Considerations - PowerPoint PPT Presentation

1 / 42
About This Presentation
Title:

Additional Assessment Considerations

Description:

Identify circumstances that promote or inhibit sleep ... Common Sleep Problems. Sleep Apnea. Insomnia. Sleepwalking. Sleep terrors. Nocturnal enuresis ... – PowerPoint PPT presentation

Number of Views:53
Avg rating:3.0/5.0
Slides: 43
Provided by: kan90
Category:

less

Transcript and Presenter's Notes

Title: Additional Assessment Considerations


1
Additional Assessment Considerations
  • Advanced Health Assessment
  • Lesson 2

2
Review Items
  • Topics listed are for general review purposes
    to serve as a reminder that each of these
    components are significant aspects of the
    assessment.
  • Notes included in pediatric growth development
    notes include lifespan family dynamics
    information also

3
Relevant Topics
  • Assessment across the lifespan
  • Family Assessment
  • Cultural Assessment
  • Nutritional Assessment
  • Sleep Assessment
  • Sexual Assessment
  • Vital Signs Lab Values

4
Assessment Across the Lifespan
  • Ericksons psychosocial theory of development
    serves as an excellent framework
  • Other theories are addressed for pediatrics in
    the handout

5
General guidelines for Dealing with Children
  • Infants
  • Young Child
  • School Age Child
  • Adolescent

6
General Guidelines for Dealing with Adults
  • Young Adult
  • Middle Age Adult
  • Aging Adult

7
Family Assessment
  • The family can be assessed in a variety of ways
  • Biologic
  • Economic
  • Educational
  • Psychological
  • Sociocultural

8
Family Definition
  • Any group of people related biologically,
    emotionally or legally.
  • Its function is to help its family members
    satisfy their needs for physical emotional
    survival

9
Family Provides for its Members
  • Esteem
  • Relief
  • Buffering mediation
  • Emotional life bonding force
  • Support system for meeting basic needs
  • Raising of children, preparing for adulthood

10
Family Function Coping
  • Family Strengths
  • Family Coping Success
  • Meeting Developmental Tasks

11
Basic Areas of Family Assessment
  • Structure Composition significant influences
  • Family Function How families interact

12
Family Composition
  • Nuclear
  • Nuclear Dyad
  • Kin Network (Extended Family)
  • Single Parent
  • Blended (Reconstituted)
  • Binuclear (Joint Custody of Children)

13
Family Composition
  • Homosexual
  • 3-Generation
  • Co-Habitating Couples
  • Single Adult (Living Alone)

14
Significant Family Influences
  • Home Conditions Community Environment
  • Occupation Education of Family Members
  • Cultural Religious Traditions

15
Family Functional Assessment
  • Family Interactions Roles
  • Power, Decision Making Problem Solving
  • Communication
  • Expression of Feelings Individuality

16
Theoretical Framework for Evaluating Families
  • Systems Theory
  • Development Theory
  • Structural-Functional
  • Interactional

17
Strong Families
  • Sense of Commitment
  • Sharing Traditions
  • Active Expression of Appreciation
  • Effective Communication
  • Spending Time Together

18
Strong Families
  • Shared Values
  • Solving Problems Coping
  • Sense of Humor

19
Difficult Family Issues
  • Missing support the less support, the more
    morbidity
  • Enmeshment - Disengagement
  • If connected by strong emotion, may resist change
    in roles behaviors of individuals
  • Change is disequalibriating disquieting

20
Difficult Family Issues
  • Paying attention to how change affects the family
    is better tolerated
  • Conflict arises when emotions attitudes are too
    far out of synchrony
  • Needs unmet dissatisfactions arise

21
Some Common Family Conflicts
  • Dominance vs. Submission
  • Closeness vs. Autonomy
  • Emotion vs. rationality
  • Over involvement vs. distancing
  • Health vs. Disease

22
Common Family Conflicts
  • Adequacy vs. Mismanagement
  • Responsibility vs. irresponsibility
  • Sharing vs. Nonsharing

23
Common Psychosocial Problems
  • Domestic conflict sexual difficulties
  • Substance abuse dependence
  • Domestic violence
  • Physical, emotional or sexual abuse of women
    children
  • Divorce
  • Financial management - mismanagement

24
Cultural Assessment
  • Culture
  • Subculture
  • Race
  • Ethnic Group
  • Minority Group
  • Customs Rituals
  • Values Cultural Norms

25
Values Affecting Health Care
  • Time Orientation
  • Activity Orientation
  • Human Nature Orientations
  • Human-Nature Orientation
  • Relational Orientations

26
Beliefs Practices
  • Folk Illness
  • Naturalistic Illness
  • Personalistic Illness
  • Specific Practices

27
Some Specific Issues
  • Coining or Moxa
  • Distant vs. close space
  • Eye contact (direct or indirect)
  • Family Authority
  • Dietary Customs
  • Ethnic Predisposition to illness

28
Nutritional Assessment
  • Major component of health maintenance
  • Identify nutritional risk
  • Over nutrition
  • Under nutrition

29
Nutritional Screening
  • Health history
  • Lifestyle habits, food choices exercise
  • Medications supplements
  • Diet History
  • 24 hour diet re-call
  • 3-4 day food recall records
  • food frequency questionnaires (6 months)

30
Comprehensive Nutritional Screening
  • Weight is lt80 or 120 of ideal weight
  • Unintended weight loss of gt4.5kg
  • Low serum albumin level
  • Low total lymphocyte count
  • History or physical exam indications

31
Subjective History Information
  • Unusual weight changes
  • Changes in appetite, taste, smell, dentition,
    chewing, swallowing
  • Recent illness, surgery, trauma, burns,
    infection, chronic illness
  • Vomiting, diarrhea, constipation
  • Food allergies or intolerances

32
Diet Evaluation Comparisons
  • Food Pyramid 6 food groups
  • Guideline 5 servings or fruits or vegetables per
    day

33
Age Related Considerations
  • Infants
  • Young Children
  • Adolescents
  • Pregnancy Breast Feeding Female
  • Older Adult

34
Objective Data Clinical Assessment
  • Skin, Hair Nails
  • Mouth
  • Musculoskeletal System
  • Cardiovascular System
  • Gastrointestinal System
  • Neurological System

35
Body Measurements
  • Height
  • Weight
  • BMI Nomogram
  • Skin Fold Thickness (TSF)
  • Mid-upper arm circumference
  • Waist-to-hip ratio

36
Laboratory Studies
  • Hemoglobin Hematocrit
  • Total Lymphocyte Count
  • Serum Albumin
  • Fasting Blood Sugar
  • Serum Lipids

37
Sleep Assessment
  • Sleep has restorative function
  • Sleep deprivation may cause changes in mood
    performance fatigue, irritability, anxiety,
    depression, feelings of persecution, poor
    concentration, feelings of depersonalization
    increased aggression

38
Sleep Assessment
  • Identify Sleep Problems
  • Evaluate quantity quality of sleep
  • Identify circumstances that promote or inhibit
    sleep
  • Identify psychological or physiological factors
    affecting sleep

39
Sleep Categories
  • Non-REM Non rapid eye movement sleep, consisting
    of 4 stages, during which no dreaming occurs
  • REM Rapid eye movement sleep, during which
    dreaming occurs
  • Both types of sleep occur during the 4-6 cycles
    of sleep occurring during an8-hour sleep period

40
Sleep Patterns with AgeHours of Sleep per Day
  • Infants 14-18
  • Young Children 10-14
  • Older Children 8-10
  • Adolescents Increase
  • Adults 7-9
  • Older Adults Awake frequently, nap

41
Common Sleep Problems
  • Sleep Apnea
  • Insomnia
  • Sleepwalking
  • Sleep terrors
  • Nocturnal enuresis

42
Sexual Assessment
  • Interviewers personal attitudes important
  • Issues different in various age groups
  • Straight forward approach useful
  • Chronic illness influence
  • Advancing age
Write a Comment
User Comments (0)
About PowerShow.com